Clinical Reasoning: Prognostication after cardiac arrest

Neurological prognostication after cardiac arrest

The care of the comatose cardiac arrest patient and his/her relatives in the ICU constitutes a major challenge for intensivists. Out-of-hospital cardiac arrest (OHCA) affects more than 275.000 Europeans yearly; survival rates are disturbingly low and have until recently remained unchanged [1]. During the last several years, significant efforts have been made to improve the quality of prehospita...

Prognostication after out-of-hospital cardiac arrest, a clinical survey

BACKGROUND Numerous parameters and tests have been proposed for outcome prediction in comatose out-of-hospital cardiac arrest survivors. We conducted a survey of clinical practice of prognostication after therapeutic hypothermia (TH) became common practice in Norway. METHODS By telephone, we interviewed the consultants who were in charge of the 25 ICUs admitting cardiac patients using 6 struc...

Prognostication of outcome after cardiac arrest and targeted temperature management

The vast majority of cardiac arrest (CA) survivors remain comatose at hospital arrival. Around one-half of these patients suffer from severe hypoxic encephalopathy leading to death or unresponsive wakefulness. Early outcome prognostication may reduce futile intensive care and suffering for next of kin. Several early prognostic markers have shown high positive predictive value for poor outcome i...

Prognostication in Post Cardiac Arrest Patients Treated with Therapeutic Hypothermia

Neurologic prognostication and bispectral index monitoring after resuscitation from cardiac arrest.

OBJECTIVE While the use of therapeutic hypothermia (TH) has improved outcomes after resuscitation from cardiac arrest, prognostication of survival and neurologic function remains difficult during the post-arrest time period. Bispectral index (BIS) monitoring, a non-invasive measurement of simplified electroencephalographic data, is increasingly being considered for post-arrest neurologic assess...